Abstract Introduction Dysphonia and lower pitch after surgery of Reinke edema are common. They are caused especially due to chronic smoking but, probably, other factors should be associated. Objectives To evaluate the results of laryngeal microsurgery in patients with Reinke edema, following a standardized postoperative guidance protocol in our service. Methods Retrospective study. Thirty patients (3 males; 27 females) were included, 70% between 41 and 60 years old. The parameters analyzed in the pre- and postoperative (between 4 and 6 months) of patients undergoing laryngeal microsurgery for Reinke edema were: smoking, vocal symptoms, videolaryngostroboscopy, voice therapy, perceptual and acoustic vocal evaluation, histopathological report. Results Smoking was reported by 100% of the patients and maintained in the postoperative period by 80%. Complete improvement of symptoms in the postoperative period was reported by 43% of them, partial improvement by 40%, and maintenance by 17%. There was low adherence to voice therapy in the pre- and postsurgery. Postoperative videolaryngoscopy indicated congestion (19), atrophy and bowed vocal fold (1), subepithelial edema (2), and normal findings (8). The histological findings were subepithelial edema, enlargement of vessels, inflammation, epithelial hyperplasia, and thickening of the basement membrane. The perceptual and acoustic vocal analyzes indicated improvement of the analyzed parameters. Conclusions The maintenance of some vocal symptoms and laryngeal alterations in videolaryngoscopy after microsurgery of Reinke edema is frequent, even in patients who follow the recommendations of vocal rest and control of gastroesophageal reflux. Vocal symptoms are attributed to changes in the laryngeal mucosa caused by chronic smoking, aggravated by the maintenance of addiction in the postoperative period.

RESUMO Este caso de ensino descreve o processo de adaptação para a virtualização do ensino no Coppead, uma das principais escolas de pós-graduação em administração no Brasil. A mudança ocorre impulsionada pelo isolamento social adotado no país por conta da pandemia de COVID-19. O caso relata as decisões que o colegiado de professores, liderado pela diretora Elaine Tavares, precisou tomar para contornar a quarentena e garantir a continuidade das aulas no Mestrado, Doutorado e MBA Executivo. Os desafios dessa transição são discutidos, porém mais importante que isso são as oportunidades estratégicas que essa experiência abre para a inovação da escola nos anos futuros.

ABSTRACT This teaching case describes the process experienced by Coppead, one of the main graduate schools in business in Brazil, to adapt to e-learning. The change is driven by the social isolation adopted in the country due to the COVID-19 pandemic. The case reports on the decisions that the faculty collegiate, led by the director Elaine Tavares, has needed to take to circumvent the quarantine and ensure teaching continuity at Master, Doctoral, and Executive MBA levels. The case discusses the main challenges during the transition, but most importantly highlights the strategic opportunities that this shift has offered for innovation in the coming years.

Resumo A intenção primordial deste artigo é apresentar elementos explicativos da conjuntura social na América Latina, desde uma mirada que se alonga e reflui ao Século XX, buscando as reminiscências do imperialismo e fascismo frente ao atual contexto socioeconômico de destrutiva ofensiva do capital. Tal ofensiva, erguida sobre os escombros dos direitos sociais das classes trabalhadoras, ganha elementos explicativos na remissão aos projetos de luta democrática, esboçados em meio a sonhos e ilusões nos primeiros anos dos anos 2000. Em nossa hipótese, vivemos, nas duas décadas do Século XXI, a reedição de processos históricos, que, todavia, ganham novas manifestações e formas particulares ao serem confrontados à dialética da luta de classes, que reatualiza a disjuntiva entre capitalismo e democracia, na submissão aos interesses imperialistas.

Abstract The goal of this article is to present explanatory elements of the social situation in Latin America, from a view that extends and goes back to the 20th century, looking for the reminiscences of Imperialism and fascism in the current socioeconomic context of the destructive advance of capitalism. This advance, built up on the wreckage of the social rights of the working classes, incorporates explanatory elements in the reference to projects of democratic struggle, outlined in the middle of dreams and illusions in the early years of the 2000s. In our hypothesis, what we live in the two decades of the 21st Century is the reissue of historical processes, which, however, incorporate new manifestations and particular forms when confronted with the dialectic of class struggle, which updates the disjunction between capitalism and democracy, in submission to imperialist interests.

Resumo Este caso apresenta o dilema vivido por Ramon Gonzales, engenheiro de telecomunicações do setor de Pesquisa e Desenvolvimento da AMPLA, uma das maiores distribuidoras de energia elétrica do Rio de Janeiro. O caso se passa no ano de 2010 quando os executivos da empresa enfrentavam diversos desafios relacionados à distribuição de energia ao mesmo tempo em que implantavam o projeto que tornaria Búzios uma cidade inteligente no que tange à energia elétrica, a chamada Smart Grid . Esse caso é indicado para sessões que tratem sobre o tema da Inovação em disciplinas como Gestão Estratégica de Tecnologia e ainda Inovação. Espera-se que os alunos discutam os conceitos de Inovação, tais como barreiras, facilidades na adoção, tipos, graus, inputs , vantagens e desafios. Além disso, mediante a discussão do caso, é possível abordar também aspectos relacionados à participação colaborativa e outros fatores intervenientes que transcendem os aspectos tecnológicos para a implantação de Cidades Inteligentes. JEL Code: K32, O32, O35.

Abstract This case study presents a dilemma that confronted Ramon Gonzales, a telecommunications engineer in the Research and Development Department of Ampla, one of the largest electricity distributors in Rio de Janeiro. It occurred in 2010 when the company's executives faced several challenges as they were developing a project that would make Buzios a smart city in terms of electricity, part of the so-called smart grid. This case is of interest in relation to Innovation in disciplines such as the Strategic Management of Technology and Innovation. It is expected that students will be able to discuss concepts of innovation, including barriers, ease of adoption, types, degrees, inputs, advantages and challenges. By discussing this case study, it will also be possible to address aspects related to collaborative participation and other intervening factors that transcend the technological aspects of implementing smart cities.

Resumo Introdução: A disfonia é um sintoma comum após a tireoidectomia. Objetivo: Analisar os sintomas vocais, auditivo-perceptivos e acústica vocal, videolaringoscopia, procedimento cirúrgico e achados histopatológicos em pacientes submetidos à tireoidectomia. Método: Estudo prospectivo. Pacientes submetidos à tireoidectomia foram avaliados da seguinte forma: anamnese, laringoscopia e avaliações vocais acústicas. Momentos: pré-operatório, 1ª avaliação pós (15 dias), 2ª avaliação pós (1 mês), 3ª avaliação pós (3 meses) e 4ª avaliação pós-operatória (6 meses). Resultados: Dos 151 pacientes, 130 eram mulheres e 21, homens. Tipos de cirurgia: lobectomia + istmectomia n = 40, tireoidectomia total n = 88, tireoidectomia + dissecção de linfonodo n = 23. Sintomas vocais foram relatados por 42 pacientes na 1ª avaliação pós-operatória (27,8%), reduzidos para 7,2% após 6 meses. Na análise acústica, f0 e APQ estavam diminuídos nas mulheres. As videolaringoscopias mostraram que 144 pacientes (95,3%) tiveram exames normais no momento pré-operatório. Paralisia das cordas vocais foi diagnosticada em 34 pacientes na 1ª avaliação pós-operatória, 32 do nervo laríngeo recorrente (lobectomia + istmectomia - n = 6; tireoidectomia total - n = 17; tireoidectomia total + dissecção de linfonodos - n = 9) e 2 do nervo laríngeo superior (lobectomia + istmectomia - n = 1; tireoidectomia total + dissecção de linfonodos - n = 1). Após 6 meses, 10 pacientes persistiram com paralisia do nervo laríngeo recorrente (6,6%). Histopatologia e correlação com paralisia das cordas vocais: bócio coloide nodular (n = 76; paralisia n = 13), tireoidite (n = 8; paralisia n = 0) e carcinoma (n = 67; paralisia n = 21). Conclusão: Os sintomas vocais, relatados por 27,8% dos pacientes na 1ª avaliação pós-operatória, diminuíram para 7% em 6 meses. Na análise acústica, f0 e APQ diminuíram. A paralisia transitória de cordas vocais secundária à lesão do nervo laríngeo recorrente e nervo laríngeo superior ocorreu, respectivamente, em 21% e 1,3% dos pacientes, reduziu-se para 6,6% e 0% após 6 meses.

Abstract Introduction: Dysphonia is a common symptom after thyroidectomy. Objective: To analyze the vocal symptoms, auditory-perceptual and acoustic vocal, videolaryngoscopy, the surgical procedures and histopathological findings in patients undergoing thyroidectomy. Methods: Prospective study. Patients submitted to thyroidectomy were evaluated as follows: anamnesis, laryngoscopy, and acoustic vocal assessments. Moments: pre-operative, 1st post (15 days), 2nd post (1 month), 3rd post (3 months), and 4th post (6 months). Results: Among the 151 patients (130 women; 21 men). Type of surgery: lobectomy + isthmectomy n = 40, total thyroidectomy n = 88, thyroidectomy + lymph node dissection n = 23. Vocal symptoms were reported by 42 patients in the 1st post (27.8%) decreasing to 7.2% after 6 months. In the acoustic analysis, f0 and APQ were decreased in women. Videolaryngoscopies showed that 144 patients (95.3%) had normal exams in the preoperative moment. Vocal fold palsies were diagnosed in 34 paralyzes at the 1st post, 32 recurrent laryngeal nerve (lobectomy + isthmectomy n = 6; total thyroidectomy n = 17; thyroidectomy + lymph node dissection n = 9) and 2 superior laryngeal nerve (lobectomy + isthmectomy n = 1; Total thyroidectomy + lymph node dissection n = 1). After 6 months, 10 patients persisted with paralysis of the recurrent laryngeal nerve (6.6%). Histopathology and correlation with vocal fold palsy: colloid nodular goiter (n = 76; palsy n = 13), thyroiditis (n = 8; palsy n = 0), and carcinoma (n = 67; palsy n = 21). Conclusion: Vocal symptoms, reported by 27.8% of the patients on the 1st post decreased to 7% in 6 months. In the acoustic analysis, f0 and APQ were decreased. Transient paralysis of the vocal folds secondary to recurrent and superior laryngeal nerve injury occurred in, respectively, 21% and 1.3% of the patients, decreasing to 6.6% and 0% after 6 months.

OBJECTIVE: Rapidly dividing cells in multiple types of cancer and inflammatory diseases undergo high low density lipoprotein (LDL) uptake for membrane synthesis, and coupling an LDL-like nanoemulsion, containing lipid nanoparticles (LDE) to a chemotherapeutic agent efficiently targets these cells without significant systemic effects. This was a prospective exploratory study that evaluated the uptake of a radioactively labeled LDE emulsion by receptors of endometriotic foci and the capacity of the LDE for cellular internalization. METHODS: The lipid profile of each patient was determined before surgery, and labeled LDE were injected into fourteen patients with intestinal or nonintestinal endometriosis. The radioactivity of each tissue sample (intestinal endometriosis, nonintestinal endometriosis, healthy peritoneum, or topical endometrium) was measured. RESULTS: The group with intestinal endometriosis presented higher levels of plasma LDL but lower LDE uptake by foci than the nonintestinal group, suggesting less cell division and more fibrosis. The uptake of LDE was highest in the topical endometrium, followed by the healthy peritoneum, and lowest in the endometriotic lesion. Since the endometriotic foci showed significant LDE uptake, there was likely increased consumption of LDL by these cells, similar to cells in cancers and inflammatory diseases. Plasma cholesterol levels had no influence on LDE uptake, which showed that the direct delivery of the nanoemulsion to target tissues was independent of serum lipoproteins. There were no significant differences in the parameters (p>0.01) because of the small sample size, but the findings were similar to those of previous studies. CONCLUSION: Nanotechnology is a promising therapeutic option for surgery and hormonal blockage for deep endometriosis, with a lower complication rate and no systemic side effects.

Resumo Objetivo: O objetivo desta pesquisa foi identificar fatores críticos de sucesso para adoção de Big Data no varejo virtual, por meio de um estudo do caso do Magazine Luiza. O uso de Big Data, no caso em análise, teve como foco o aprimoramento de seu sistema de recomendações para melhor compreensão do comportamento do consumidor. Metodologia: O estudo do caso se deu por meio de entrevistas, observação do sistema de recomendação de compras e análises de apresentações institucionais do projeto Bob. Um roteiro de entrevista semiestruturado foi utilizado nas entrevistas. Resultados: Mediante os resultados apresentados, traçamos algumas proposições relacionadas às oportunidades e barreiras para a implementação de Big Data no varejo virtual no Brasil. Algumas dessas proposições se alinham ao que a literatura, principalmente de BI, já vinha discutindo. De qualquer forma, elas ainda precisam ser discutidas no contexto do Big Data. Contribuições: A principal contribuição da pesquisa foi a identificação de fatores relevantes para a adoção de Big Data que não eram apontados como críticos para a adoção de tecnologias anteriores.

Abstract Purpose: - The objective of this research was to identify critical success factors for the adoption of Big Data in the virtual retail, through a case study of Magazine Luiza. The use of Big Data, in this case, focused on improving its system of recommendations for a better understanding of consumer behavior. Design/methodology/approach: The case study was done through interviews, observation of the shopping recommendation system and analyzes of institutional presentations of the Bob project. A semi-structured interview script was used in the interviews. Findings: Based on the results, we outline some propositions related to the opportunities and obstacles for the implementation of Big Data in the virtual retail in Brazil. Some of these propositions are in line with what literature, especially BI, has been discussing. However, they still need to be discussed in the context of Big Data. Originality/value: The main contribution of the research was the identification of relevant factors to the adoption of Big Data that were not considered as critical for the adoption of previous technologies.

OBJECTIVE: To test the hypothesis that intravenous use of methotrexate associated with lipid nanoemulsions can achieve superior anti-inflammatory effects in the joints of rabbits with antigen-induced arthritis compared with commercial methotrexate. METHODS: Arthritis was induced in New Zealand rabbits sensitized with methylated bovine serum albumin and subsequently intra-articularly injected with the antigen. A nanoemulsion of methotrexate labeled with 3H-cholesteryl ether (4 mg/kg methotrexate) was then intravenously injected into four rabbits to determine the plasma decaying curves and the biodistribution of the methotrexate nanoemulsion by radioactive counting. Additionally, the pharmacokinetics of the methotrexate nanoemulsion were determined by high-pressure liquid chromatography. Twenty-four hours after arthritis induction, the animals were allocated into three groups, with intravenous injection with saline solution (n=9), methotrexate nanoemulsion (0.5 µmol/kg methotrexate, n=7), or commercial methotrexate (0.5 µmol/kg, n=4). The rabbits were sacrificed 24 h afterward. Synovial fluid was then collected for protein leakage and cell content analyses and synovial membranes were collected for histopathological analysis. RESULTS: The methotrexate nanoemulsion was taken up mainly by the liver and the uptake by arthritic joints was two-fold greater than that by control joints. The methotrexate nanoemulsion treatment reduced leukocyte influx into the synovial fluid by nearly 65%; in particular, mononuclear and polymorphonuclear cells were reduced by 47 and 72%, respectively. In contrast, cell influx was unaffected following treatment with commercial methotrexate. Protein leakage into the arthritic knees of the rabbits was also more limited following methotrexate nanoemulsion treatment than following commercial methotrexate treatment. CONCLUSIONS: The intravenous methotrexate nanoemulsion showed anti-inflammatory effects on the synovia of arthritic joints that were clearly superior to the effects of a commercial methotrexate preparation. This result is conceivably due to greater methotrexate uptake by the joints when the drug is associated with a nanoemulsion.

Introdução: Disfonia psicogênica é um distúrbio vocal funcional com diversas manifestações clínicas. Objetivo: Apresentar as características clínicas e vocais de uma série de pacientes com disfonia psicogênica. Tipo de estudo: estudo de série. Método: Foram incluídos 28 pacientes adultos com disfonia psicogênica atendidos em um Hospital Universitário. Parâmetros analisados: sexo, idade, profissão, sintomas, características vocais, e achados videolaringoestroboscópicos. Resultados: 28 pacientes (26 mulheres e dois homens). Profissão: domésticas (n = 17), professor (n = 4), vendedor (n = 4), enfermeiro (n = 1), aposentado (n = 1) e psicóloga (n = 1). Sintomas de inicio súbito reportados por 16 pacientes e progressivo por 12; curso intermitente dos sintomas foi reportado por 15 pacientes. A duração dos sintomas acima de 3 meses foi referido por 21 pacientes. A videolaringoestroboscopia identificou apenas alteracões funcionais (nenhum paciente apresentou lesões estruturais ou de mobilidade das pregas vocais). Principais apresentações da disfonia psicogênica: afonia de conversão, tensão músculo esquelética e quebra de sonoridade. Conclusões: Nesta série de casos de pacientes com diagnóstico de disfonia psicogênica a forma de apresentação clínica mais frequente foi a afonia de conversão, seguida pela tensão músculo esquelética e sonoridade intermitente. Discutimos os aspectos clínicos e vocais de 28 pacientes com o diagnóstico de disfonia psicogênica e as particularidades de cada caso.

Introduction: Psychogenic dysphonia is a functional disorder with variable clinical manifestations. Objective: To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series. Methods: The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings. Results: 28 patients (26 women and 2 men) were assessed. Their occupations included: housekeeper (n = 17), teacher (n = 4), salesclerk (n = 4), nurse (n = 1), retired (n = 1), and psychologist (n = 1). Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms. Conclusions: In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed.

The aim of this article is to analyze the impacts, based on the perceptions of managers, of the deployment of a model to govern the relationship between business areas and IT in a large Brazilian financial organization.  To undertake the case study of this deployment, the research firstly performed documental analyses of the process and then sent electronic surveys to a sample of managers in order to evaluate their perceptions of the model’s impact in terms of the formalism of the organization’s internal processes, strategic alignment between business areas and IT and levels of governance in the organization.  The results revealed that managers perceived improvements in the quality of technological solutions, levels of IT governance, the understanding of IT area needs and business area demands, but they also stated that the negotiating process was more complex and there was no increase in their level of satisfaction with IT. These results of the study may contribute to the development of instruments for the evaluation of the impacts of the deployment of relationship models on important organizational aspects.

A pesquisa descrita neste artigo teve como objetivo analisar como a tecnologia da informação (TI) vem sendo utilizada para auxiliar a gestão da cadeia de suprimentos (GCS) na cidade de São Luís, Maranhão. Os resultados retratam quais tecnologias são mais empregadas e quais são pouco utilizadas, assim como benefícios e barreiras para adotá-las. Revela-se um cenário de oportunidades para o uso efetivo da TI, que poderá contribuir para o desenvolvimento local, por meio da mudança de realidade de seus fornecedores.

The research described in this article aims to examine how information technology (IT) has been applied in supply chain management (SCM) in the city of São Luís, Maranhão. Results indicate which technologies are most used and which are not widely applied, as well as benefits and barriers to this adoption. It reveals a scenario of opportunities for the effective use of IT, which could contribute to local development, through the changing reality of its suppliers.

La investigación descrita en este artículo tiene por objeto analizar cómo la tecnología de la información (TI) se ha utilizado em la gestión de la cadena de suministro en São Luís - Maranhão. Los resultados indican las tecnologías más utilizadas y que casi no se usan, así como los beneficios y los obstáculos para su adopción. Se revela un escenario de oportunidades para el uso eficaz de las TI, que pueden contribuir al desarrollo local, a través de la cambiante realidad de sus proveedores.

La recherche décrite dans cet article vise à examiner comment les technologies de l'information (TI) a été utilisé sur la gestion de la chaîne d'approvisionnement à São Luís, Maranhão. Les résultats indiquent que technologies sont les plus utilisés et qui ne sont pas largement utilisé, ainsi que les avantages et les obstacles à cette adoption. Il se révèle un scénario de possibilités pour l'utilisation efficace des TI, ce qui pourrait contribuer au développement local, à travers la réalité changeante de ses fournisseurs.

OBJETIVO: Investigar as alterações laríngeas e vocais em pacientes com sintomas de refluxo gastroesofágico e correlacioná-las com o exame de phmetria. MÉTODOS: Estudo prospectivo que incluiu os pacientes atendidos nos ambulatórios de Distúrbios da Voz da Faculdade de Medicina de Botucatu no período de cinco anos com sintomas vocais e gastroesofágicos. Os pacientes foram submetidos à videolaringoscopia, às análises vocais perceptivo-auditivas, a analise vocal acústica computadorizada e ao exame de pHmetria de dois canais com monitorização durante 24 horas. RESULTADOS: Foram incluídos 57 pacientes (entre 21 a 65 anos; 45 mulheres e 12 homens). Desses, 18 apresentavam pHmetria normal (31,6%) e 39 alterada (68,4%). As videolaringoscopias registraram diversas lesões laríngeas tanto nos pacientes com pHmetria normal como alterada, sendo mais relevantes neste último grupo, destacando-se a paquidermia posterior. As avaliações vocais perceptivo-auditivas identificaram alterações vocais de diversas intensidades em ambos os grupos, mais importantes nos pacientes com pHmetria alterada. Todos os parâmetros acústicos, exceto Fo, mostraram-se alterados em ambos os grupos, quando comparados aos controles. CONCLUSÕES: Alterações vocais perceptivas e acústicas, e lesões laríngeas foram registradas tanto nos pacientes com phmetria normal como alterada, sinalizando para a importância da historia clínica e dos achados videolaringoscópicos no diagnóstico das laringites ácidas.

PURPOSE: To investigate laryngeal and voice disorders in patients with gastroesophageal symptoms and their correlation with pH-monitoring. METHODS: A prospective study was carried out in patients attended at the Voice Disorder Outpatient Clinics of Botucatu Medical School in a five-year period and had vocal and gastroesophagic symptoms. Patients underwent videolaryngoscopy, auditory-perceptual vocal analyses, computerized acoustic vocal analysis and dual probe pH-monitoring for 24 hours. RESULTS: Fifty-seven patients were included (aged between 21 and 65 years; 45 women and 12 men), 18 had normal (31.6%) and 39 had abnormal pH-monitoring results (68.4%). Videolaryngoscopy recorded several laryngeal lesions for both patients with normal and abnormal pH-monitoring, but mostly for the latter group, highlighting posterior pachyderma. Auditory-perceptual vocal assessments identified vocal changes of several intensities for both groups but especially for patients with abnormal pH-monitoring results. All acoustic parameters, except f0, were abnormal for both groups, compared to the control population. CONCLUSION: Acoustic and perceptual vocal changes and laryngeal lesions were recorded for both patients with normal pH-monitoring results and patients with abnormal pH-monitoring results, evidencing the importance of clinical history and videolaryngoscopic findings for diagnosing acid laryngitis.

Este artigo apresenta os resultados de uma pesquisa realizada com o objetivo de entender em que condições se dá a construção social de sistemas de informação (SI) no setor bancário no Brasil. Foi realizada uma análise da implantação, do uso e dos processos de aprimoramento de três sistemas, usados em duas instituições bancárias. Parte-se da premissa de que a tecnologia da informação (TI) é um fenômeno socialmente construído, com uma estrutura de uso formada na prática. A coleta de dados envolveu observação direta, análise documental e 46 entrevistas. Revelou-se um processo de construção social que gerou quatro tipos de uso dos SI. A assimilação dos sistemas foi influenciada pela confluência de objetivos individuais e organizacionais e pelo tipo de treinamento aplicado. As atualizações e revisões dos sistemas parecem seguir estruturas de conformismo com o que foi instituído pela organização e de conformidade com processos de solicitações de aprimoramentos.

This article presents the results of research into an understanding of the conditions in which the social construction of information systems in the Brazilian banking sector is developed. It analyses the implementation, use and enhancement process of three information systems at two banks in Brazil. The research was based on the assumption that information technology is a social construction phenomenon, with a structure of use created in practice. Data were collected through observation, analysis of documents and 46 interviews. A process of social construction was found that produced four types of use of information systems. The system adoption was influenced by the confluence of individual and organizational objectives and by the type of training applied. System updates and reviews seem to follow structures of conformism to what was institutionalized by the organization and of conformity with the process of requests for enhancements.

Estudos sobre disfonias infantis apontam incidência entre 4,4 a 30,3% das crianças. OBJETIVOS: Determinar a prevalência de disfonia em crianças, baseando-se nos julgamentos dos pais, nas ava-liações vocais perceptivas e acústicas, analisar sintomas associados, fatores de risco e achados vide-olaringoscópicos. CASUÍSTICA E MÉTODOS: Os pais de 2.000 crianças responderam questionário sobre qualidade vocal do filho. As crianças foram submetidas às avaliações vocais perceptiva, acústicas e videolaringoscopias. RESULTADOS: Participaram 1.007 meninos e 993 meninas. Sintomas esporádicos foram reportados por 206 pais e permanentes, por 123. Na avaliação perceptiva, o parâmetro G (Grau de disfonia) recebeu escore 0 em 694 vozes, 1 em 1065 e 2 em 228. Houve diminuição de f0 com a idade e os demais parâmetros acústicos mostraram-se mais elevados nas crianças com escore de G em 2. Nas videolaringoscopias, destacaram-se nódulos, espessamentos e inflamação. CONCLUSÕES: O julgamento dos pais indicou prevalência de disfonia em 6,15%, e as análises perceptivas em 11,4%. Os sintomas vocais relacionaram-se à sobrecarga fonatória. Quadros nasossinusais, abuso vocal e ruído foram importantes fatores de risco. As análises acústicas mantiveram relação direta com as perceptivo-auditivas. Lesões laríngeas foram detectadas nas videolaringoscopias, destacando nódulos, espessamentos e inflamação.

Children dysphonia studies have reported an incidence of 4.4 to 30.3%. GOALS: To establish the prevalence of dysphonia in children, based on the opinion of the parents, acoustic and vocal-perceptual assessments, associated symptoms, risk factors and videolaryngoscopy findings. MATERIALS AND METHODS: The parents from 2,000 children answered a questionnaire about the vocal quality of their children, and these children were submitted to perceptual vocal, acoustic and videolaryngoscopy assessments. RESULTS: We had 1,007 boys and 993 girls; sporadic symptoms were reported by 206 parents and permanent symptoms were reported by 123. In the perceptual assessment, the G parameter (degree of dysphonia) had a score of 0 in 694 voices; 1 in 1,065 and 2 in 228. There was f0 reduction with age and the remaining acoustic parameters were high in children with a G score of 2. Nodules, thickening and inflammation were the most common in the videolaryngoscopy exams. CONCLUSIONS: Parental judgment indicated a prevalence of dysphonia in 6.15%, and perceptual analysis yielded a value of 11.4%. Vocal symptoms were associated with a phonatory overload. sinonasal disorders, vocal abuse and noise were considered relevant risk factors. The acoustic analysis kept a direct association with the perceptual-auditory. Laryngeal lesions were found in the videolaryngoscopy exams, stressing nodules, thickening and inflammation.

A pesquisa descrita neste artigo teve como objetivo analisar como a tecnologia da informação (TI) vem sendo utilizada para auxiliar a gestão da cadeia de suprimentos (GCS) na cidade de São Luís do Maranhão. Os resultados retratam quais tecnologias são mais empregadas e quais são pouco utilizadas, assim como benefícios e barreiras para esta adoção. Revela-se um cenário de oportunidades para o uso efetivo da TI, que poderá contribuir para o desenvolvimento local, por meio da mudança de realidade de seus fornecedores.

The research described in this article aims to examine how information technology (IT) has been applied in supply chain management (SCM) in the city of São Luís do Maranhão. Results indicate which technologies are most used and which are not widely applied, as well as benefits and barriers to this adoption. It reveals a scenario of opportunities for the effective use of IT, which could contribute to local development, through the changing reality of its suppliers.

La investigación descrita en este artículo tiene por objeto analizar cómo la tecnología de la información (TI) se ha utilizado em la gestión de la cadena de suministro en São Luís do Maranhão. Los resultados indican las tecnologías más utilizadas y que casi no se usan, así como los beneficios y los obstáculos para su adopción. Se revela un escenario de oportunidades para el uso eficaz de las TI, que pueden contribuir al desarrollo local, a través de la cambiante realidad de sus proveedores.

La recherche décrite dans cet article vise à examiner comment les technologies de l'information (TI) a été utilisé sur la gestion de la chaîne d'approvisionnement à São Luís do Maranhão. Les résultats indiquent que technologies sont les plus utilisés et qui ne sont pas largement utilisé, ainsi que les avantages et les obstacles à cette adoption. Il se révèle un scénario de possibilités pour l'utilisation efficace des TI, ce qui pourrait contribuer au développement local, à travers la réalité changeante de ses fournisseurs.